School of Health, Care and Social Welfare, Mälardalen University, Vasteras, Sweden.
Cardiothoracic Surgery Intensive Care Unit (CTSICU), New York, New York, USA.
Nurs Crit Care. 2024 Sep;29(5):1142-1150. doi: 10.1111/nicc.13053. Epub 2024 Feb 23.
Intrahospital transport (IHT) is often performed by nurse anaesthetists and specialist intensive care nurses. Studies have shown that IHT increases the risk of mortality and morbidity, with up to 71% negative incidents. Using checklists when preparing for an IHT is important. Several international guidelines exist to ensure IHT safety and reduce the risk of complications. However, existing guidelines are often problematic in clinical practice.
This study aimed to describe the experiences of nurse anaesthetists and specialized intensive care nurses during the IHT of adult patients with critical illnesses.
This study adopted a mixed-methods approach.
Data were collected through a questionnaire completed by 66 nurses with specialist education in anaesthesia or intensive care. The data were analysed with qualitative content analysis, and the quantitative data were analysed with descriptive statistics.
Two categories with two subcategories each emerged from the analysis of the responses of nurse anaesthetists and specialist intensive care nurses regarding their IHT experiences: creating good circumstances (subcategories: being risk-conscious and the importance of meticulous preparations) and the importance of routines and education (subcategories: following guidelines and having adequate training).
IHT was described as a high risk for patient safety and complications. Routines with good compliance and education can positively impact patient safety during IHT. Checklists and scenario training can better prepare nurse anaesthetists and specialist intensive care nurses to manage complications that may arise during IHT, resulting in safer patient care.
The findings underscore the importance of written guidelines for IHT, emphasizing awareness and adherence by the entire team. Careful pre-IHT preparations, coupled with an understanding of potential risks, are vital for ensuring patient safety. Clinical training and discussions following incidents during IHT play a crucial role in raising the collective awareness of patient safety within the entire team. Written guidelines about IHT are of utmost importance, and everyone in the team should be aware of and follow the guidelines. It is important to make careful preparations before IHT and to be aware of the possible risks to patient safety. Clinical training and discussions about IHT where patient safety has been impaired are important to increase the whole team's awareness of patient safety during IHT.
院内转运(IHT)通常由麻醉护士和重症监护专科护士执行。研究表明,IHT 会增加死亡率和发病率,高达 71%的转运存在负面事件。在准备 IHT 时使用检查表非常重要。有几项国际指南可确保 IHT 安全并降低并发症风险。然而,现有的指南在临床实践中常常存在问题。
本研究旨在描述麻醉护士和重症监护专科护士在转运危重症成人患者时的经验。
本研究采用混合方法。
通过对 66 名接受过麻醉或重症监护专科教育的护士进行问卷调查收集数据。使用定性内容分析对数据进行分析,使用描述性统计对定量数据进行分析。
对麻醉护士和重症监护专科护士关于 IHT 经验的回答进行分析后,出现了两个类别,每个类别又有两个亚类:创造良好环境(亚类:风险意识和细致准备的重要性)和常规和教育的重要性(亚类:遵循指南和接受足够培训)。
IHT 被描述为患者安全和并发症的高风险。良好依从性和教育的常规操作可以对 IHT 期间的患者安全产生积极影响。检查表和情景训练可以更好地为麻醉护士和重症监护专科护士做好准备,以应对 IHT 期间可能出现的并发症,从而实现更安全的患者护理。
研究结果强调了书面 IHT 指南的重要性,强调了整个团队的意识和遵守情况。仔细的 IHT 前准备,加上对潜在风险的理解,对于确保患者安全至关重要。IHT 期间发生并发症后的临床培训和讨论对于提高整个团队对患者安全的集体意识起着至关重要的作用。书面 IHT 指南至关重要,团队中的每个人都应了解并遵守指南。在进行 IHT 之前,仔细准备并注意可能对患者安全造成的风险非常重要。IHT 期间发生患者安全受损后的临床培训和讨论对于提高整个团队在 IHT 期间对患者安全的意识非常重要。